(Select All That Apply): A nurse is assessing a client for major depressive disorder (MDD). Which of the following signs and symptoms are consistent with the clinical presentation of MDD? Select all that apply.
Increased interest in activities.
Weight gain of 3% in a month.
Excessive guilt and self-blame.
Insomnia.
Elevated mood and increased energy.
Correct Answer : C,D
Choice A rationale:
Increased interest in activities is not consistent with the clinical presentation of MDD. In fact, a hallmark symptom of MDD is anhedonia, which involves a reduced interest or pleasure in most activities.
Choice B rationale:
Weight gain is not typically associated with MDD. In contrast, significant changes in appetite and weight loss are more common symptoms, often accompanied by feelings of worthlessness or guilt related to body image.
Choice C rationale:
Excessive guilt and self-blame are common cognitive and emotional symptoms of MDD. Individuals with MDD tend to have a negative self-perception and may blame themselves for their difficulties.
Choice D rationale:
Insomnia, or difficulty falling asleep or staying asleep, is a common sleep disturbance associated with MDD. Sleep problems can exacerbate the symptoms of depression and impact overall well-being.
Choice E rationale:
Elevated mood and increased energy are actually more indicative of conditions like bipolar disorder or manic episodes, where there are distinct periods of abnormally elevated mood, known as mania or hypomania.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E"]
Explanation
Choice A rationale:
Symptoms of major depressive disorder (MDD) are characterized by causing significant distress, not mild distress. The distress associated with MDD is usually severe and impairs daily functioning.
Choice B rationale:
While insomnia is a common symptom of major depressive disorder (MDD), it is not necessary for the diagnosis. Other symptoms, such as changes in appetite, psychomotor agitation or retardation, fatigue, and diminished interest or pleasure, can also contribute to the diagnosis.
Choice C rationale:
The correct answer. Symptoms of major depressive disorder (MDD) must not be due to a medical condition. It's crucial to rule out medical conditions that can mimic depressive symptoms, such as hypothyroidism or certain neurological disorders.
Choice D rationale:
The presence of a manic or hypomanic episode would indicate a diagnosis of bipolar disorder, not major depressive disorder (MDD). Bipolar disorder involves distinct periods of both elevated mood and depressive episodes.
Choice E rationale:
The correct answer. To meet the diagnostic criteria for major depressive disorder (MDD) according to DSM-5, an individual must experience five or more symptoms of depression during a continuous two-week period. These symptoms must include either depressed mood or loss of interest/pleasure. The scenario did not specify all the symptoms, but the persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described align with the criteria.
Correct Answer is D
Explanation
Choice A rationale:
"MDD is less severe than dysthymia but lasts for at least 2 years." This statement is incorrect. Major Depressive Disorder (MDD) is characterized by the presence of a major depressive episode, which can be severe and persistent, lasting for at least two weeks. Dysthymia, on the other hand, is a chronic but milder form of depression that lasts for at least two years, not MDD.
Choice B rationale:
"Dysthymia is characterized by alternating episodes of mania and depression." This statement is incorrect. Dysthymia is a chronic mood disorder characterized by a persistent low mood and other depressive symptoms. It does not involve alternating episodes of mania and depression. Alternating episodes of mania and depression are characteristic of bipolar disorder, not dysthymia.
Choice C rationale:
"Unlike MDD, dysthymia does not impair social or occupational functioning." This statement is incorrect. Both Major Depressive Disorder (MDD) and dysthymia can significantly impair social, occupational, and other areas of functioning. In fact, dysthymia's chronic nature often leads to long-term impairment in various aspects of an individual's life, similar to MDD.
Choice D rationale:
"Dysthymia is chronic and lasts for at least 2 years, but is less severe than MDD." This statement is accurate. Dysthymia is a chronic form of depression that persists for at least two years. While it may not exhibit the same level of severity as a major depressive episode, its long-term nature can still have a substantial impact on an individual's quality of life. This distinguishes it from MDD, which can have episodic occurrences.
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